Peripherally inserted central catheter (PICC)

Your child might be sent home from hospital with the PICC still inserted. You will need to make sure the PICC is well taken care of to avoid infection and keep it working properly.

Your child’s doctor or nurse will give you instructions on how to take care of the PICC. Your child will also have check-ins with the hospital in the home (HITH) nurse to make sure everything is working properly.

The following tips can help you look after the PICC.

Hygiene

• wash hands carefully and wear gloves when connecting and disconnecting the infusion sets from the PICC and when changing the dressing
• make sure that the ends of the PICC, infusion sets, and syringe tips do not touch any surfaces that are not sterile (completely free of germs).

Showering

• make sure the dressing covering the PICC is kept clean and dry at all times
• for baths, make sure the PICC is kept out of the water to prevent infection
• for showers, cover the PICC with plastic clingwrap and use tape at each end so it stays dry.

Dressing

• check the dressing throughout each day to make sure it is secure and not peeling off
• change the PICC dressing every 7 days, carefully following the instructions given by your child’s treatment team
  • changing the dressing can involve carefully removing the old dressing and cleaning the skin around the PICC with antiseptic solution, before applying a new clean dressing.

Checking the line

• check the PICC line (tube) to make sure it is not kinked or bent
• check the line outside the body has not changed in length (shorter or longer)
• be careful when helping your child to get dressed, making sure the PICC is not accidently removed.

Avoiding damage

• make sure that your child does not do any contact sports or rough play to avoid damage to the PICC
• do not allow anyone to touch the PICC.

The following information is about issues that can happen with a PICC line at home, and what to do.

Your child has chest pain or difficulty breathing

1. clamp the PICC
2. call the ambulance on triple zero (000)
3. lie your child on their left side with their head down.

Your child develops a fever or signs of infection

Stop the infusor, clamp the line and take your child to the nearest emergency department if your child develops:

• a fever
• swelling, redness, or pain at the PICC entry site
• swelling, redness or pain up the arm.

The PICC accidentally comes out

1. lie your child down and apply firm pressure over the site with cotton wool or a clean
2. disposable towel for 5 minutes to stop the bleeding
3. once bleeding stops, cover the site with a spare dressing
4. contact your child’s treatment team or HITH nurse.

The Infusor has disconnected from the PICC

1. clamp the line, do not attempt to reconnect the PICC
2. contact your child’s treatment team or HITH nurse.

The PICC breaks

1. stop the infusion
2. clamp the line above the break, closest to the skin where the PICC has been inserted
3. if you are unable to clamp the line, bend the line above the break and tape the line firmly together
4. cover with a clean dressing or a clean disposable towel to keep clean
5. secure the PICC with spare dressing
6. contact your child’s treatment team or HITH nurse.

The dressing is loose, wet or dirty

1. do not remove the dressing
2. secure the dressing with spare, clean dressing
3. contact your child’s treatment team or HITH nurse.

The PICC appears longer or shorter

1. secure the PICC with spare dressing to prevent further movement
2. contact your child’s treatment team or HITH nurse.

There is leaking or drainage at the PICC site

1. stop the infusor and clamp the PICC
2. contact your child’s treatment team or HITH nurse.

Your child will have the PICC removed when treatment is finished, or it is not working like it should be. The PICC can be removed easily by a specially trained doctor or nurse. Your child will not need to go under general anaesthetic to have the PICC removed.

Flushing is when a normal salt water or saline solution is pushed in the PICC line by a syringe. This helps to stop it from becoming blocked and is done after medication or nutrition has been given.

Locking is when an anti-blood clotting and antibacterial solution is left in the PICC line when it is not being used. This is typically done when the PICC does not need to be used for up to one week and stops infection from happening and the line from becoming blocked.

Because the PICC line sits close to the heart, there is a small risk that it could damage or puncture the wall of blood vessels or of the heart. A serious infection or blood clot could also develop. These complications are extremely rare but can be life threatening.

Your child’s doctor will talk to you about the PICC, the risks and the benefit before your child has the procedure. Make sure you ask any questions you have about the PICC and caring for the line.